Dementia and the Carer #DementiaAwarenessWeek


 

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There are currently 800,000 people with dementia in the UK.

Over 17,000 are younger people with dementia and there will be over a million people with dementia in the UK by 2021.

I have witnessed dementia first hand. I had an uncle that suffered this awful illness it not only robbed him of his life but my Auntie lost the life she had shared with him for 60 years. She cared for him with love and dignity 24/7 until the day he died.

She was a proud woman whose pride wouldn’t let her ask for help. I feel the illness actually affected her more in so many ways than it did him.

Whist he lived in his own world, she would try to give him normality. He was extremely well looked after, always well fed, clothed and entertained – sadly he never remembered any of this, he struggled to remember most things. The days that he was like his old self sadly became fewer and fewer.

It was starting to take its toil on my Auntie. She had many sleepless nights when he would be up walking around the house looking for the cat that they didn’t have, shouting out the window at 2 am at the cows that were walking down the main road with the fireman behind them signing Twinkle Twinkle Little Star, the smell of burning when he put a plastic bowl filled with water onto the electric cooker. The flooded kitchen when he left the hot tap running all night and the lovely flowers that he had planted with such love and care some years before ripped from the ground and tossed in a pile in the middle of the garden.

He would go from being calm and almost like his “old self” to being rude and aggressive. He could be hurtful in things he would say to her. On a couple of occasions he would have an outburst of violence and because of that she actually starting being afraid of him. She never knew what was coming next.

With my help we managed to get him a place in a day centre 2 days a week. I could see the relief in her eyes when this was sorted. She planned to use those days to have her hair done, take a long hot bath without fear he might be getting up to no good and shopping with her friend, the simple things of life that most of us take for granted. This all came to a crushing end when he point blank refused to go, he wanted to be at home with his Maureen. She gave in and the hairdressers and the shops were put on hold.

When they went out she had to get taxi’s. Travelling on buses was not an option anymore, he had caused too many scene. She used a local taxi company who understood her needs, but this all came at a cost she could ill afford.

I could go on, anyone that has ever known someone with dementia will understand that what I have said is just a tip of the iceberg. Those that have never come across a family devastated by this awful illness count yourself lucky, and I hope you never do.

She told me she got up to another bleak day ahead to find he had a temperature and was generally unwell, he couldn’t tell her what was wrong but she just knew as well as the dementia there was something else going on, he was more aggressive and he was not in the best of form. She phoned the surgery and asked for a visit, the surgery asked if she could come down, not being one to cause a fuss she took the appointment offered to her for 09.30.

She had to get my Uncle up from bed, bath him, help him dress and try and get him to take some breakfast, and then get him to the surgery for his appointment. It was one of those days that he really didn’t want to oblige. She recalled as they got to the surgery the waiting room was full. She struggled to keep him in one place. His voice raised at times getting a lot of attention from others in the waiting room. A couple of mothers gathered their children closer. He started to get aggressive and started shouting, and then he stood up in front of everyone and wet himself. My poor Auntie was mortified. She felt sick, she wanted the ground to open up and swallow her. She told me she went to the Reception Desk and was so relieved to find the “nice Receptionist” there. The Receptionist showed them into a side room and went and got the nurse.

The nurse suspected that he might have had a urine infection. That was the easy part; they then had to try and get him to do a sample. He wasn’t having any of it and didn’t cooperate one bit. Finally after a lot persuasion they got the sample and with a script my Auntie started her journey home having to face getting my wet uncle bathed and dressed again for the 2nd time that day and it wasn’t even 11.00.

I tried to support my Auntie as much as I could. There were times she would let her barrier down and really tell me how she felt. She told me she often felt very isolated and confessed that at times she resented my Uncle, with a tear in her eye she admitted that sometimes she would snap at him through sheer exhaustion and as she looked at that betrayed look in his eyes and she would be eaten up with guilt. She was tired, lonely and most of all she felt that she had already lost him, this beautiful, caring most gentle husband who would always go out of his way to help others who had fallen a victim to this horrible disease.

I don’t know how she coped. It was the sheer love for him that got her through those bleak dark days.

I tried to get her help, but she refused. She saw it as her duty to look after him without a thought for herself.

The support for the carer is every bit as important as it is for the patient. They are unsung heroes.

There are 670,000 carers of people with dementia in the UK and these carers of people with dementia save the UK over £8 billion a year.

Carers can be family, friends or paid workers. They will often accompany the person they are caring for to a Doctors appointment, be it at the Surgery or Hospital. It is important that people with dementia have regular check-ups and equally as important for the carer to have regular check-ups.

My Auntie often found it difficult to get appointments to fit in caring for her husband. Early morning or late evening appointments were the worse for her. My uncle would not get up until late morning and for her that gave her the chance of getting things done in the house, and if she woke him early it would often result in him having a bad day.

It is important that anyone caring for someone is giving consideration and understanding as their life is difficult enough.

 

Sadly my uncle died. She was eaten up with grief, asking herself could she have done more. Lost in the endless time she now faced. Friends had moved away, neighbours she didn’t know anymore.

She was suffering another loss for a second time.

 

© 2011-2017 Reception Training all rights reserved
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Supporting The Receptionist


 

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I recently held a training session for a group of new Receptionists. They ranged from being in their current posts from 6 weeks through to 6 months.

I particularly enjoy New Receptionists Training. I love the group participation and the eagerness to learn more about the role of the Receptionist. Each person came from a different organisation but all have the same goal, wanting to do their job to the best of their ability.

And they can only achieve their best by being trained to do so. You as employer, a manager team leader or fellow Receptionist owe it to any new members to the team and help them to achieve that ultimate goal. You also owe it to you patients and customers by having well-trained staff.

I try to make they training session interesting, including ice breakers and lots of team participation. One of the exercises we did was “What would you have found useful in your role when you first started ”. This question raised a lot of answers, and we had a great discussion around each one.

Some feedback to the question included:

  • More training – especially around confidentiality
  • Knowing who does what in the organisation (staff list and their main roles)
  • Days and hours of staff working at the organisation.
  • Up to date telephone list.
  • Knowing the 999 policy
  • More training on the phone system
  • Emergency procedure for Reception
  • Disability awareness – especially wheelchair users.
  • Knowing what staff are in and out of the building
  • How to deal with a difficult caller
  • Who to report to when the Receptionist has a query (some were still confused on who to report to)
  • Need for more policies and procedures for the Reception area
  • Daily/weekly checklist for new Receptionists.

We discussed all of the above in great detail. Many of the group had no idea of their emergency procedures. Some didn’t know if their reception area had a panic button and some spoke of having a difficult caller and admitted that they found this really difficult to deal with. 75% of the group didn’t know that their “fancy” Reception desk was in fact a desk designed for people with a disability and everyone agreed that they would have found a daily/weekly checklist helpful when they first started, thus reducing the amount of time they had to keep asking other members of the team.

Many admitted that they felt uncomfortable dealing with people with a disability, the fear of getting it wrong and upsetting the person, and because of that fear they felt that they didn’t approach the person in the way that they deserved.

Some of the group said that they felt inadequate having to keep asking over and over again what to do. Some simply were left to find out everything themselves and others felt that they have been given great support. A mixture but every single one of them all said that they felt regular ongoing training was important.

Receiving feedback after the course brought some of the following comments:

  • Training is very beneficial
  • Understanding the importance of team building
  • Dealing with difficult people at the front desk and over the telephone.
  • The importance of confidentiality in the workplace.
  • Feeling confident and being able to ask if they were not sure
  • Felt more confident after the session
  • Knowing that a lot of what they are doing they are doing right.

I asked what training they would feel would benefit them further in their role and the feedback was

  • Confidentiality
  • Disability Awareness
  • Telephone Skills
  • Dealing With Difficult Situations in Reception.

Do you have regular contact with new Receptionists? Do you have any idea if they are struggling with any aspects of their role?

I always met with a new Receptionist after they had been in the job a week, then I would meet with them after a month, and again at 3 months. The meeting was a 2 way process – for them to understand what we expected from them, and to find out if we could do anything for them to support them in their role and to identify training needs.

 

© 2011-2017 Reception Training all rights reserved

Signposting – Have you got it right?


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I accompanied an elderly friend to the hospital yesterday. She had to go to see the neurologist.

I went with her as a friend but to also support her as she is in a lot of pain and finding walking difficult.

Parking as in most hospitals was pretty awful; we were lucky to find a space and then made our way into the hospital with plenty of time before her appointment was due. We entered the large outpatients department and found that they had completely reorganised the main area. There used to be an information desk, this now replaced by a super new coffee shop.

There was no sign to direct us to the neurology department so I stopped and asked two maintenance men who were deep in conversation propping up the door. One of them told us we had to follow the corridor to the end through the double doors and turn right, into the new part of the building. So off we went.

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We went through the double doors, and there were no signs of our destination. So I asked another member of staff, she sent us back the way we had come, and once again we ended up somewhere that certainly wasn’t neurology.

I then asked a 3rd person who actually told us truthfully that they had no idea where it was, by this point my friend was starting to struggle with her walking, I sat her down and asked a 4thperson. This member of staff asked me to follow her and she took me directly to the department which was situated right beside the two maintenance men who were still there chatting. I went back and collected my friend and we made our way back to check in.

We waited at the empty reception desk, still not confident that we were in the right department, and the time was fast coming up to her appointment,my friend started getting anxious as she does not like to be late.

The Receptionist finally arrived, apologised for keeping us waiting and asked her name. Thank goodness we were in fact in the right place – more by chance I might like to add.

I asked the Receptionist why there was a lack of signposting and she told me that there were several outpatients clinics held there on a daily/weekly basis and they would be unable to list them all, and often they change to other parts of the department.

So, Hospitals, large GP Surgeries and Health Clinics please ensure that your signposting is user-friendly and if for some reason if have not got a help desk, or you cannot put up the correct signs, please think of putting directions on the appointment letters, and perhaps appropriate training for staff in how to deal with patients/visitors when they are asking for directions. If staff are not fully confident that they know where the departments are, then tell the patient that, please don’t send them on a wild goose chase like we were yesterday.

Large buildings that have lack of signposting can often be confusing to the elderly and the disabled.

 

© 2011-2017 Reception Training all rights reserved

The Sunshine Patient


 

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Working on the front desk as a Receptionist you deal with thousands of patients over the years. But there are those few patients that will always stay in your mind for different reasons. If I think back to the many lovely patients I use to deal with one that automatically springs to mind is Andrew (I have changed his name for this story).

Let me tell you about Andrew and how he used to lighten up my day when he came into the surgery. He was like a ray of sunshine.

Andrew used to come in on a fairly regular basis with his Dad. Andrew was 25 years old and had Downs Syndrome.

It was just Andrew and his Dad – on getting to know them more I found out that sadly Andrew’s mum had died in their house due to Carbon monoxide poisoning. Andrew and his dad were extremely lucky to pull through – but it was so obvious how they missed their wife and mum.

When I first started dealing with Andrew and his Dad on the front desk it was always his dad that made the appointments, did the talking and insisted on going into see the doctor with Andrew.

The doctor that Andrew (and his dad) used to see on a regular basis was concerned that Andrew was not being allowed to be more independent and do more for himself – but the Doctor also identified that this was mainly down to Andrew’s dad not wanting to “let go”. Andrew was all he had in the world. But at the same time it was not fair to Andrew he was being held back.

After some months getting to know Andrew and his Dad Andrew started to really come out of himself and would chat away at the front desk to me he would joke and laugh with me. I always got a great big beam from him when he came into Reception.

Andrew would happily tell me about his day – what they had done that morning and what there were going to do that afternoon. I always looked forward to his visits and the stories he had to tell.

Then Andrew starting to hold the conversation more every time he came in. Andrew even started to book his next appointment by himself and actually started going in to see the doctor on his own. I seen Andrew grow with such confidence. The doctor that Andrew was seeing was extremely supportive and understood Andrews needs so well.

When Andrew was in with the doctor one morning his dad was chatting to me at the desk. He opened up to his fears about Andrew, and confessed that he actually felt that he was holding Andrew back, but Andrew was all he had.  He confessed that he had even put a block on Andrew attending a day centre as he didn’t want to let go. I felt so sorry for his dad and for Andrew too. His main fear was that Andrew would die and he would be left with no one. The love he had for Andrew was amazing but he was holding him back.

Andrew continued to flourish and he even got a bit bold at times – in a nice way. The cheeky chap even tried to chap me up for his dad once and asked if I would go to their house for fish and chips that Friday night – it was all in good fun and he understood that I couldn’t go as I had to get home to my two girls.

Andrew’s confidence continued to grow, with the help of the GP his dad finally agreed that Andrew could go to a day centre – Andrew just loved it there. His eyes would sparkle when he told me about his days there and the friends that he had made.

But his dad’s fears of loosing Andrew never went away.

Life continued in the surgery and Andrew and his Dad’s visit became less frequent. Andrew was becoming much more independent and loved his days at the centre.

Then one Monday morning I was checking through the out of hours reports and to my horror seen that there had been a death at their address – Andrew’s dad had died of a massive heart attack.

I never got to see Andrew again – and never knew what happened to him, but one thing for sure I know that wherever he went he would have brightened up their days just like he had done to mine whenever he came into the surgery.

I would like to think that the independence that Andrew gained over the years would have given him some strength to get through the loss of his Dad.

 

© 2011-2017 Reception Training all rights reserved

Patients with Dyslexia


Many people are Dyslexic. Dyslexia means problems with

  • Reading
  • Writing
  • Spelling
  • Symbols
  • Numbers

Many have been accused of being

  • Dumb
  • to stupid to learn
  • mentally slow
  • thick
  • no hope

Because the brain misinterprets what it sees (visual) and hears (auditory). Dyslexia does not affect the intelligence of a person. In fact many dyslexic people are highly intelligent. (see link below)

For others they are quite open to tell you than they have Dyslexic. If this is the case ask the person if there is anything you can do to help such as completing forms etc.

If you have a patient that comes to the desk they might not have the ability to read and write, and might not be comfortable sharing this information with you. Many people have grown up without realising that they have got dyslexia. They have often had to struggle though life without help and support that many get these days. For these patients they find it hard to tell people often strangers that they cannot read or write.

If you have to ask a patient to complete a form at the desk and they object please do make an issue out of it.

Patients will often say that they are in a rush and can they “take the form home” which means that someone at home will help them complete the form. If this is possible let the patient take the form away – but give them some guidelines if the form has to be back by a certain time. Quite often letting someone take a form home can result it them not bringing it back again. This often happens when a new patients requests to join the practice.

Patients will often say that they cannot complete the form because they have left their glasses at home. Again, this could be because they have difficulty reading and writing – what you could do in this instance is ask if they would like you to help them complete the form, and if you cannot do it perhaps ask another colleague to come and help. This way the person is not embarrassed and the form gets completed. By doing this you are offering to help without embarrassing the patients.

With the right encouragement, support and strategies many dyslexic people can learn to read and write.

People that have dyslexia are far from being stupid, thick, dump or lazy. Did you know that there are many famous people who are dyslexic – and have gone on and achieve so much in their life – regardless to what they were told when they were younger?

Here is a short clip – did you know how many of these people live with Dyslexia